autonomic dysfunction
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2022 ◽  
pp. 97-117
Christopher H. Gibbons ◽  
Nicholas J. Silvestri

2022 ◽  
Vol 237 ◽  
pp. 102907
Ahmed N. Sahly ◽  
Michael Shevell ◽  
Lynette G. Sadleir ◽  
Kenneth A. Myers

2021 ◽  
Vol 15 ◽  
Andrew P. Owens ◽  
Christopher J. Mathias ◽  
Valeria Iodice

Background: There have been previous reports of enhanced sympathoexcitation in autism spectrum disorder (ASD). However, there has been no formal investigation of autonomic dysfunction in ASD. Also, the joint hypermobile form of Ehlers-Danlos syndrome (hE-DS) that maybe overrepresented in ASD and orthostatic related autonomic dysfunction. This study examined the comorbidity of ASD, autonomic dysfunction and hE-DS in two UK autonomic national referral centers. Proven, documented and globally accepted clinical autonomic investigations were used to assess neuro-cardiovascular autonomic function in a cohort of ASD subjects and in age-matched healthy controls.Methods: Clinical data from 28 referrals with a confirmed diagnosis of ASD over a 10-year period were compared with 19 age-matched healthy controls. Autonomic function was determined using methods established in the centers previously described in detail.Results: 20/28 ASD had a diagnosed autonomic condition; 9 had the postural tachycardia syndrome (PoTS), 4 PoTS and vasovagal syncope (VVS), 3 experienced presyncope, 1 essential hyperhidrosis, 1 orthostatic hypotension, 1 VVS alone and 1 a combination of PoTS, VVS and essential hyperhidrosis. 16/20 ASD with autonomic dysfunction had hE-DS. In ASD, basal heart rate and responses to orthostatic tests of autonomic function were elevated, supporting previous findings of increased sympathoexcitation. However, sympathetic vasoconstriction was impaired in ASD.Conclusion: Intermittent neuro-cardiovascular autonomic dysfunction affecting heart rate and blood pressure was over-represented in ASD. There is a strong association with hE-DS. Autonomic dysfunction may further impair quality of life in ASD, particularly in those unable to adequately express their experience of autonomic symptoms.

Sensors ◽  
2021 ◽  
Vol 22 (1) ◽  
pp. 266
Brindha Anbalagan ◽  
Sunitha Karnam Karnam Anantha ◽  
Sridhar P. Arjunan ◽  
Venkatraman Balasubramanian ◽  
Menaka Murugesan ◽  

Early diagnosis of Parkinson’s disease (PD) plays a critical role in effective disease management and delayed disease progression. This study reports a technique that could diagnose and differentiate PD from essential tremor (ET) in its earlier stage using a non-motor phenotype. Autonomic dysfunction, an early symptom in PD patients, is caused by α-synuclein pathogenesis in the central nervous system and can be diagnosed using skin vasomotor response to cold stimuli. In this study, the investigations were performed using data collected from 20 PD, 20 ET and 20 healthy subjects. Infrared thermography was used for the cold stress test to observe subjects’ hand temperature before and after cold stimuli. The results show that the recovery rate of hand temperature was significantly different between the groups. The data obtained in the cold stress test were verified using Pearson’s cross-correlation technique, which showed that few disease parameters like medication and motor rating score had an impact on the recovery rate of hand temperature in PD subjects. The characteristics of the three groups were compared and classified using the k-means clustering algorithm. The sensitivity and specificity of these techniques were analyzed using an Receiver Operating Characteristic (ROC) curve analyzer. These results show that this non-invasive technique can be used as an effective tool in the diagnosis and differentiation of PD in its early stage.

Sarah D. Schlatterer ◽  
Rathinaswamy B. Govindan ◽  
Jonathan Murnick ◽  
Scott D. Barnett ◽  
Catherine Lopez ◽  

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S6.2-S7
Divya Jain ◽  
Kristy Arbogast ◽  
Catherine McDonald ◽  
Olivia Podolak ◽  
Susan Margulies ◽  

ObjectiveTo explore the utility of an eye-tracking assessment in distinguishing binocular alignment, saccadic movement, and pupillary dynamics among uninjured adolescents, acute cases (= 28 days since concussion), and persistent cases (>28 days since concussion).BackgroundVisual and autonomic system disturbances are common sequelae of concussion. Quantification of visual and autonomic dysfunction via an eye tracking device could provide an objective method of acute diagnosis and subacute identification of ongoing injury.Design/MethodsWe compared 347 eye tracking metrics, derived from a 220 seconds eye-tracking assessment, among 132 uninjured adolescents (mean age: 15.3, 56.2% female), 110 acute cases (mean days since injury: 12.5, mean age: 15.4, 46.4% female), and 95 persistent cases (mean days since injury: 53.6, mean age: 15.4, 70.2% female) using Kruskal-Wallis tests with Bonferroni corrections to account for multiple comparisons.ResultsNine eye-tracking metrics were significantly associated with injury status. One measure of binocular alignment (acute v. control: p = 0.003, persistent v. control: p = 0.001) and one measure of saccadic movement (acute v. persistent: p = 0.03, acute v. control: p = 0.03, persistent v. control: p < 0.001) were worse in cases. Cases had larger left and right mean and median pupil size than uninjured adolescents (acute v. control, p < 0.001; persistent v. control, p < 0.001). Cases had greater differences in mean (acute v. control: p < 0.001, persistent v. control: p < 0.001), median (acute v. control, p < 0.001, persistent v. control, p = 0.003), and variance of (acute v. control: p < 0.001, persistent v. control: p < 0.001) left and right pupil size. Eight of these metrics distinguished female cases from uninjured adolescents, but similar differences were not observed in male participants.ConclusionsObjective eye tracking technology can identify vision and pupillary disturbances after concussion. These metrics could be integrated into clinical practice to monitor recovery in a heterogeneous adolescent concussion population and may identify sex-specific differences in autonomic dysfunction.

2021 ◽  
pp. 494-496
Tony K S ◽  
Rakhee Joshi ◽  
Pradnya Chaudhari ◽  
Reshma Abraham ◽  
Nachiket Joshi ◽  

Acute intermittent porphyria (AIP) is a rare autosomal dominant and the most severe form of the inherited hepatic porphyrias, affecting mainly young women. We present the case of an 18-year-old female who presented with severe abdominal pain, purple urine, autonomic dysfunction, and severe hyponatremia, seizures on further evaluation came out to be a case of AIP. This case report is a reminder to keep AIP among the differentials in young female patients with a classic constellation of abdominal urine discoloration syndrome of inappropriate secretion of antidiuretic hormone and autonomic dysfunction.

2021 ◽  
Vol 50 (1) ◽  
pp. 364-364
Lindsay Laws ◽  
Sung-Min Cho ◽  
Ajit Munjuluru ◽  
Romergryko Geocadin ◽  
Daniel Swedien

2021 ◽  
Vol 10 (24) ◽  
pp. 5861
Simone Bellavia ◽  
Irene Scala ◽  
Marco Luigetti ◽  
Valerio Brunetti ◽  
Maurizio Gabrielli ◽  

Coronavirus disease-19 (COVID-19) is a predominantly respiratory syndrome. Growing reports about a SARS-CoV-2 neurological involvement, including autonomic dysfunction (AD), have been reported, mostly in critically-ill patients, or in the long-COVID syndrome. In this observational, cross-sectional study, we investigated the prevalence of AD in 20 non-critically-ill COVID-19 patients (COVID+ group) in the acute phase of the disease through a composite instrumental evaluation consisting of Sudoscan, automated pupillometry, heart rate variability (HRV), and pulse transit time (PTT). All the parameters were compared to a control group of 20 healthy volunteers (COVID− group). COVID+ group presented higher values of pupillary dilatation velocities, and baseline pupil diameter than COVID− subjects. Moreover, COVID+ patients presented a higher incidence of feet sudomotor dysfunction than COVID− group. No significant differences emerged in HRV and PTT parameters between groups. In this study we observed the occurrence of autonomic dysfunction in the early stage of the disease.

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